| Premise Health Of Illinois Medical, Pc | |
|
6150 Joliet Rd Countryside IL 60525-3956 | |
| (708) 485-2273 | |
| (708) 352-0845 |
| Full Name | Premise Health Of Illinois Medical, Pc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 6150 Joliet Rd, Countryside, Illinois |
| Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
| Authorized Official Contact | 2164799063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premise Health Of Illinois Medical, Pc 5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () - | Premise Health Of Illinois Medical, Pc 6150 Joliet Rd Countryside IL 60525-3956 Ph: (708) 485-2273 |
| NPI Number | 1083006001 |
|---|---|
| Provider Enumeration Date | 02/27/2015 |
| Last Update Date | 08/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083006001 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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